tbuckley/cabot-search huggingface dataset:
AB0545 EFFECT OF BELIMUMAB ON CLINICAL PROFILES AND DAILY LIVING SCORE IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)
Authors: T. Ishizuka, K. Fujioka, M. Tangiku, H. Tani, A. Maeda, A. Kato
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Belimumab (BE) was shown to decrease disease activity, glucocorticoid intake, and flare rates, thereby suppression of damage progression, and also has been included in the 2019 EULAR recommendations on SLE management as an approved biological drug to be used in patients with a refractory response to a standard of care regimen. <h3>Objectives</h3> We have examined the effect of belimumab on activities of daily living score (AS), immunological data, disease activities and dose of PSL in patients with SLE. <h3>Methods</h3> We selected 36 cases (F/M 30/6) from 2018 to 2022 in patients with SLE treated with BE (iv or sc) to clarify the effect of BE on immunological data, disease activities (SLEDAI), AS (Lupus 26: 849, 2017), and dose of PSL after treatment for 6 months (M), 12 M and 24M. <h3>Results</h3> Mean BMI and duration of disease were 20.5±3.7 kg/m2 and 15.7±13.8 years. Two cases could not continue due to arthralgia and loss of hair within 24 M. After treatment with BE for 6 M and 12 M, anti-dsDNA antibodies (AU/ml) were significantly decreased for 12 M and 24 M, respectively (p&lt;0.05, before 61±103, 6M 28±48, 12 M 19±23), and C3, C4 and CH50 (U/ml) were significantly increased (p&lt;0.05, before 76±26, 14±7 and 28.7±10.8, 6 M 186±18, 18±7 and 35.3±9.2, 12M 85±18, 18±7 and 135.3±9.2). Levels of SLEDAI score were significantly decreased (p&lt;0.01, before 12±7, 6M 5±3, 12 M 4±3 and Doses of PSL (mg) were significantly decreased (p&lt;0.05-0.02, before 10.8±10.6, 6 M 6.1±3.7, 12 M 5.7±3.0). AS scores were also significantly improved (p&lt;0.01-0.05), before 28.4±14.2, 12 M 14.8±15.8, 24 M 16.8±10.9). Especially, anxiety, depression and loss of concentration, which were important marker for activities of living score, were not significantly changed. <h3>Conclusion</h3> Effects of BE on immunological data, disease activities, and daily living scores, induction of clinical remission and dose reduction of prednisolone were tolerable without major adverse effects in patients with SLE. <h3>Reference</h3> [1]Fanouriakis A et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann Rheum Dis 2019; 78:736-45. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0592 COMPARATIVE CARDIOVASCULAR RISK IN PATIENTS WITH OLDER-ONSET SYSTEMIC LUPUS ERYTHEMATOSUS: A NATIONWIDE RETROSPECTIVE COHORT STUDY IN KOREA
Authors: J. Han, S. K. Cho, Y. Jeon, G. Kang, H. Kim, S. Y. Jung, E. J. Jang, Y. K. Sung
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Patients with systemic lupus erythematosus (SLE) have increased mortality related to cardiovascular disease (CVD) and the age is one of important risk factors for the development of CVDs. However, the comparative risk of CVDs in patients with older onset SLE has not been well studied. <h3>Objectives</h3> This study aims to compare the CVD risk in patients with SLE occurred after the age of 40 compared to those with DM. <h3>Methods</h3> Incident SLE patients aged over 40 years and age-sex matched (1:4:4) controls with DM or general population were identified from the nationwide claims database in Korea between 2008 and 2018. We defined CVD risk as ischemic heart disease, stroke, and cardiac death. The incidence rates (IR) and incidence rate ratio (IRR), and adjusted hazard ratio (HR) of CVDs were calculated using generalized estimating equation models. <h3>Results</h3> We identified 4,272 SLE, 17,003 DM, and 17,088 general population patients aged over 40 years. Their mean age was 53.1 (±9.7) and 81.7% of them were female. The IR per 1,000 person-years (PYs) of CVDs for SLE, DM, and general population were 16.8, 11.7, and 5.7, respectively. Compared to general population, patients with SLE (IRR 3.27, 95% CI 2.78-3.85) and DM (IRR 2.77, 95% CI 2.02-2.56) showed higher CVD risk compared to general population. Increased risk of CVDs in SLE patients was highest in their forties (IRR 4.13, 95% CI 3.06, 5.59). After adjusting confounders, the CVD risk of SLE (HR 1.99, 95% CI 1.66-2.38) was higher than DM (HR 1.39, 95% CI 1.22-1.58) patients. <h3>Conclusion</h3> Older onset SLE patients had increased CVD risk compared to general population. Even after adjustment for confounders, SLE patients showed higher CVD risk than DM patients in Korea. <h3>Acknowledgements</h3> This research was supported by a grant of the Korea Health Technology R&amp;D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health &amp; Welfare, Republic of Korea (grant number: HI19C1202). <h3>Disclosure of Interests</h3> None Declared.
AB0681 HISTORY OF ABORTION AND MULTIPARITY IN SYSTEMIC AUTOIMMUNE DISEASES: RESULTS FROM A MULTIDISCIPLINARY PREGNANCY CLINIC (GYNECOLOGY, RHEUMATOLOGY AND NEPHROLOGY)
Authors: C. Sieiro Santos, H. Park, B. Magallares, H. Marco, E. Llurba, M. Díaz, S. Ros, P. Moya, J. L. Tandaipan, C. Díaz-Torné, C. Pitarch, S. P. Fernandez-Sanchez, A. Laiz, J. Torguet, H. Codes, I. Castellví, H. Corominas
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Pre-conception counselling and risk stratification performed in a multidisciplinary clinical setting with rheumatologists, obstetricians and nephrologists may improve pregnancy outcomes in systemic autoimmune disease (SAD). <h3>Objectives</h3> To compare clinical, obstetrical comorbidities and pregnancy outcomes in patients with SAD with history of pregnancy loss with patients without history of pregnancy loss. <h3>Methods</h3> A retrospective cohort study was conducted. A total of 41 patients with SADs that attended the multidisciplinary preconception outpatient clinic were included. Variables related to SADs, obstetric comorbidities and pregnancy outcomes were collected. Description of the sample and comparison of groups were carried out. Shapiro-Wilk test was used to study normality. <h3>Results</h3> The description and comparison of the comorbidities, preconception counselling and pregnancy outcomes are summarized in Table 1. A total of 18 (46%) patients had a history of pregnancy loss. Fewer patients with history of pregnancy loss, 38.5% were fit for conception compared to 54.3% of patients with a history of pregnancy loss. Deferment of pregnancy was advised for 38.5% of patients with history of pregnancy loss and 54.3% in patients without history of pregnancy loss. Patients with a history of pregnancy loss had significantly higher anti-DNAds, antiphospholipid positivity and longer time since last flare.There was no significant difference for adverse pregnancy outcomes, disease activity or treatment. Interestingly, the distribution of risk profile for adverse pregnancy was different between both groups: there were more moderate and high risk for adverse pregnancy in patients with a history of pregnancy loss. <h3>Conclusion</h3> Patients with a history of pregnancy loss present delay to plan a new pregnancy, higher anti-DNA and antiphospholipid positivity. No worse pregnancy outcomes were observed. <h3>Disclosure of Interests</h3> None declared
AB0441 JANUS KINASES INHIBITORS THERAPY FOR THE TREATMENT OF RHEUMATOID ARTHRITIS: AN OVERVIEW OF SYSTEMATIC REVIEWS AND META-ANALYSES
Authors: X. Shen, X. Guo, X. Gao, J. Zhang, X. Hou, Z. Feng
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Janus kinases (JAK) inhibitors are a family of intracellular tyrosine kinases that act as hubs in the signaling process of many cytokine receptors, mediating inflammation and autoimmune diseases. It was reported that JAK inhibitors played an important role in inhibiting bone destruction by inhibiting the phosphorylation of proteins. In recent years, JAK inhibitors have been widely used to treat Rheumatoid Arthritis(RA).and proved to have an obvious curative effect. However, the efficacy and safety of the clinical use of JAK inhibitors need to be further verified. <h3>Objectives</h3> To access the methodological, reporting and evidence quality of systematic reviews and meta-analyses of JAK inhibitors for RA. <h3>Methods</h3> We comprehensively searched the literature in CNKI, Wanfang Data, VIP, PubMed, Web of Science databases from inception to November 2022. A Measurement Tool to Assess systematic Reviews (AMSTAR-2) tool and the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) were used to access the methodological and reporting quality. The level of evidence quality was evaluated by employing the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) scale. <h3>Results</h3> The AMSTAR-2 tool showed that half of the included literature had low quality, and the other 6 literatures had a very low quality. The study process lacked certain normativity, which had a certain impact on the implementation of the study and the evaluation of outcomes. The PRISMA statement showed that there were numerous vulnerabilities in the methodology module of each document, which was mainly manifested in the scheme and registration. The GRADE analyses showed that the quality of the evidence for the outcome measures was moderate to low. The results showed that JAK inhibitors had certain advantages in the proportion of patients with ACR20, 50 and 70 after treatment for 3 months or 6 months. In addition, this study found that JAK inhibitors could alleviate adverse reactions. Furthermore, all the included literature had certain deficiencies in randomization, blinding, allocation, etc. There was a risk of bias, which directly reduced the evidence level of RCT trials and showed that the included studies had defects in the design of trial protocols. <h3>Conclusion</h3> The effectiveness of JAK inhibitors for RA has certain advantages compared with placebo, and more studies need to be demonstrated than other drugs. However, the safety is uncertain and need further explored. <b>Keywords:</b> JAK inhibitors Rheumatoid arthritis; AMSTAR-2; PRISMA; GRADE. <h3>Disclosure of Interests</h3> None Declared. <b>Funding:</b>This project was supported by grants from National Natural Science Foundation of China (No. 81703783 and 81503415); <h3>Disclosure of Interests</h3> None Declared.
AB0506 DOES JANUS KINASE INHIBITOR INCREASE THE RISK OF HERPES ZOSTER IN PATIENTS WITH RHEUMATOID ARTHRITIS IN SAUDI ARABIA? A MULTICENTER RETROSPECTIVE COHORT STUDY
Authors: O. Abudaowd, S. Attar, F. Ahmed, G. Salama, H. Almoallim, R. Kaki
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Currently, there is an advancing interest in the Janus kinase (JAK) intracellular pathway since targeted inhibitors are proving to be excellent in the treatment of Rheumatoid arthritis (RA). Nevertheless, this new therapeutic era of small molecules comes at a cost, JAKi is associated with a heightened risk of reactivation of dormant infections herpes zoster (HZ) virus infection. Furthermore, the incidence of HZ in rheumatoid arthritis using JAKi is higher in eastern Asian countries making this study essential for the assessment of its safety among the middle eastern population in a real-world setting. <h3>Objectives</h3> To evaluate the risk of serious infection (SI) and herpes zoster (HZ) in rheumatoid arthritis patients receiving JAK inhibitors. <h3>Methods</h3> Multicenter retrospective cohort study in Saudi Arabia. Rheumatoid arthritis patients aged 18 and above from the period of 2007-2022 were included. Medical records were reviewed, and patients were phone interviewed during 2022 to register an outcome of HZ infection. Chi-square was used to assess for the correlation between various risk factors and HZ infection. <h3>Results</h3> From a total of 308 patients, 108 were on JAKi. JAKi didn't significantly increase the risk of HZ development (OR1.97, 95% CI 0.71- 4.67). Rather, patients on Etanercept had higher risk of HZ (OR 2.88, 95% CI 1.65-2.83). 3 out of the 7 cases who developed HZ were on chronic corticosteroid. However, it wasn't significantly associated with HZ devolvement. Patients with Asian ethnicity were significantly more predisposed to HZ infection (OR 1.2, 95% CI 0.8-4.37). None of the patients received the vaccine prior to HZ infection. <h3>Conclusion</h3> In this multicenter study in Saudi Arabia, JAKi were not associated with the development of HZ among Rheumatoid Arthritis patients in real world setting. Asian ethnicity and etanercept usage were significantly associated with HZ infection. <h3>References</h3> [1]Bechman, Katie, et al. "A Systematic Review and Meta-Analysis of Infection Risk with Small Molecule JAK Inhibitors in Rheumatoid Arthritis." <i>Rheumatology</i>, vol. 58, no. 10, 2019, pp. 1755–1766., doi:10.1093/rheumatology/kez087. [2]Jamilloux, Yvan, et al. "JAK Inhibitors for the Treatment of Autoimmune and Inflammatory Diseases." <i>Autoimmunity Reviews</i>, vol. 18, no. 11, 2019, p. 102390., doi:10.1016/j.autrev.2019.102390. [3]Sunzini, Flavia, et al. "JAK Inhibitors and Infections Risk: Focus on Herpes Zoster." <i>Therapeutic Advances in Musculoskeletal Disease</i>, vol. 12, 2020, doi:10.1177/1759720x20936059. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0687 CHRONIC SCLEROSING SIALADENITIS, IS IT A SJÖGREN’S SYNDROME OR NOT?
Authors: E. J. Kwon, B. W. Lee, Y. Park, J. J. Lee, S. H. Park, S. K. Kwok
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The Sjögren's syndrome (SS) is a chronic autoimmune disease. The classification criteria of SS have been evolved through the decades. Recent in 2016, American college of rheumatology (ACR)–European Alliance of Associations for Rheumatology (EULAR) classification requires at least one positive finding in either the labial salivary gland biopsy or anti-Ro (SSA) serology for the confirmation of SS. Chronic sclerosing sialadenitis (CSS) is unusual, underrecognized condition that affects the salivary gland, reported by H. Kutter at first. <sup>[1]</sup> Though the CSS already has been eliminated from the diagnostic criteria of SS, there is controversy in the meaning of CSS in SS. And that makes it difficult to determine whether the patient who suffers from sicca symptom is SS or not. <h3>Objectives</h3> Investigating the clinical meaning of CSS in association with SS by comparing the clinical and laboratory findings, we provide the extent of understanding CSS, the rare pathologic condition of salivary gland. <h3>Methods</h3> This study is a single center retrospective study, including patients confirmed as CSS via biopsy in Seoul St. Mary's Hospital from 2000 to 2022. (1) Patients with history of head and neck radiation, (2) graft-versus-host disease (GVHD), (3) IgG4-RD, (4) positive biopsy result in IgG4 immunohistochemistry (IHC) staining, and (4) insufficient pathologic result to distinguish IgG4-RD from CSS were excluded. 21 of 27 CSS patients were eligible to our analysis. 4 of positivity with IgG4 in IHC staining positivity, 1 of GVHD, and 1 of prior head and neck radiation were excluded. We assessed 239 patients from 341 of the Korean Initiative of primary SS (KISS) prospective cohort study as SS control group, eligible to 2016 classification. <h3>Results</h3> In CSS group, only 1 of 21 was diagnosed as SS. Table 1 summarizes the result. 'CSS as SS' consisted of CSS patients meeting 2016 criteria, assuming that the CSS could be a part of SS pathology. <h3>Conclusion</h3> The CSS were once inculeded in pathologic category of SS. However, it is a distinct phenotype separated from SS in such aspects of the (1) age of onset, (2) proportion of occular manifestation, (3) autoimmune profiles, and (4) stimulated salivary flow rate. Thus, physicians should also consider the possibility of CSS in old age patient with xerostomia. <h3>References</h3> [1]Küttner H. "Über entzündliche Tumoren der Submaxillar-Speicheldrüse." Beitr Klin Chir, 15 (1896): 815-828 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0670 MYOSITIS IN PRIMARY SJÖGREN’S SYNDROME: DATA FROM A MULTICENTRE COHORT
Authors: K. Chandwar, S. Pandya, K. N. Thomas, P. Srivastava, A. Wakhlu
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Primary Sjögren's syndrome (pSS) is a multisystem autoimmune disease characterised by lymphocytic infiltration of the exocrine glands and their resultant dysfunction. Muscle involvement has been given the highest weightage in the ESSDAI score Given the significant variation in prevalence (0.85–14%) and characteristics of myositis patients with pSS across studies (Owing to heterogeneous definitions and assessment) it is vital for us to understand myositis in pSS better. <h3>Objectives</h3> The aim of this study was to describe the prevalence of myositis in a multicentre Indian pSS cohort and to address the clinical manifestations and therapeutic strategies. <h3>Methods</h3> Clinical and serological data from a pSS cohort of patients were retrospectively collected and analysed. Those fulfilling the ACR/EULAR 2017 criteria for myositis and the ACR/EULAR 2012 Criteria for pSS were included. Patients with overlap features of other autoimmune rheumatic diseases were excluded. <h3>Results</h3> 12 (2.7%) out of 444 patients of pSS had Myositis. The mean age was 36.83 ±12.16 years, and the mean duration of follow-up was 5,46 ±5.23 years. All patients were females with a high prevalence of ANA positivity and Ro52, and Ro60 in these patients. Myositis was the presenting manifestation in 11/12 patients. Arthritis/Arthralgia (8/66%), Glandular enlargement/ Parotitis (7/58%), Lung Involvement (ILD) (5/41%), and Haematological abnormalities were also common in patients with myositis and primary Sjögren's syndrome. The 5-year survival was good, with 11/12 patients completing the 5-year follow-up. About a half patients received pulse methylprednisolone therapy followed by 1mg/kg steroid, with few patients requiring lower doses of steroids. Methotrexate was the steroid sparing drug of choice for patients with pSS myositis without lung involvement and Cyclophosphamide in patients with lung invelvement followed by Azathioprine or Rituximab maintenance, one patient was induced and maintained with low dose rituximab. Details of second-line therapy was not available for three patients. The mean ESSDAI and ESSPRI scores were high. None of our patients had Signs, symptoms or histopathological findings suggestive of IBM. <h3>Conclusion</h3> pSS patients with myositis had a younger age of onset with active Disease and High ESSDAI and ESSPRI scores. Myositis was the presenting manifestation in most, the proportion of patients with lung involvement in pSS myositis was much higher than is usually seen in patients with pSS and should prompt the clinician to look for clinical/subclinical lung involvement in pSS myositis patients. The Response to therapy was usually good. Unlike other cohorts, we didn't find any IBM in our set of patients – this may be due to referral bias or the rarity of IBM in the Indian population. <h3>Disclosure of Interests</h3> None declared
AB0715 THE LONG-TERM PROGNOSTIC VALUE OF THE “2022 ACR/EULAR CLASSIFICATION CRITERIA FOR TAKAYASU ARTERITIS”: DATA FROM A LARGE MONOCENTRIC COHORT
Authors: A. Tomelleri, C. Campochiaro, E. Rinaldi, N. Viapiana, E. Baldissera, L. Dagna
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The "2022 classification criteria" for Takayasu arteritis (TAK) have been developed for the purpose of classifying patients with TAK. These criteria provide a score from 0 to 22; a score ≥5 allows to classify a patient. <h3>Objectives</h3> To investigate whether the "2022 classification criteria" score correlates with long-term outcomes of patients with TAK. <h3>Methods</h3> Data of patients with TAK followed up for ≥1 year and evaluated at least once within the last year at our Vasculitis Clinic were reviewed. For each patient, the score provided by the "2022 classification criteria" at baseline was calculated and the following outcomes at 24, 60, 120 months were evaluated: glucocorticoid (GC) suspension, introduction of a conventional disease-modifying anti-rheumatic drug (cDMARD), introduction of a biologic DMARD (bDMARD), need for vascular procedure, total number of bDMARDs received. Correlation of these outcomes with the score and with different thresholds (scores ≥5, ≥6, ≥7) was evaluated. Statistical tests were performed as appropriate. <h3>Results</h3> 120 TAK patients were included (103 women, 87.3%); mean follow-up duration was 154±113.8 months (24 months, n=110, 60 months, n=88, 120 months, n=60). Mean age at diagnosis was 37.3±13.6 years. 112 patients (93%) were classified as having TAK (mean score, 9.5±3). Seven patients (5.8%) were only treated with GC; 110 patients (91.6%) received at least one cDMARD (mean, 1.6±1), after a mean of 23.6±61.1 months; 80 patients (66.7%) received at least one bDMARD (mean, 1.2±1.5), after a mean of 40.1±64.5 months. GCs were suspended in 44 patients (36.7%), after a mean of 102.3±93.7 months. Forty-four patients (36.7%) underwent at least one vascular procedure (mean, 0.9±1.5). No significant correlation between the five outcomes and the score was found at all three timepoints (Table 1). No significant correlation between GC suspension, introduction of a csDMARD or a bDMARD, need for a vascular procedure and a score ≥5, ≥6, or ≥7 was found at all three timepoints (Table 1). A significant correlation between the total number of bDMARDs received at 120 months and both scores ≥6 and ≥7 was found (1.3±1.5 vs 0.6±0.8, p=0.045, and 1.3±1.6 vs 0.6±0.7, p=0.035, respectively). <h3>Conclusion</h3> Although the "2022 classification criteria for TAK" do not seem to correlate with the long-term prognosis, in our cohort we found that a higher baseline score (≥6) is associated with a higher number of bDMARDs received during follow-up. This suggests that the score might allow to identify TAK patients with a more refractory disease. These preliminary data need to be replicated in larger cohorts. <h3>References</h3> [1]Grayson PC, et al. Ann Rheum Dis. 2022;81(12):1654-1660 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.